Provider Demographics
NPI:1003025834
Name:LINCOLN PASTORAL COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:LINCOLN PASTORAL COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARE
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:GRAMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:217-732-6225
Mailing Address - Street 1:PO BOX 441
Mailing Address - Street 2:1700 N. JEFFERSON ST.
Mailing Address - City:LINCOLN
Mailing Address - State:IL
Mailing Address - Zip Code:62656-0441
Mailing Address - Country:US
Mailing Address - Phone:217-732-6225
Mailing Address - Fax:217-732-7272
Practice Address - Street 1:1700 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:IL
Practice Address - Zip Code:62656-1047
Practice Address - Country:US
Practice Address - Phone:217-732-6225
Practice Address - Fax:217-732-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health